We are often asked by hospital administrators, pharmacists and physicians what it takes to start or grow a hospital’s specialty pharmacy.
Since creating our first hospital specialty pharmacy program in 2012, we have considered it the Golden Rule of Specialty Pharmacy to place patient care at the center of the business model.
This golden rule is central for establishing what we call the three levers of a successful Hospital Specialty Pharmacy, which are as follows:
- ACCESS: Access to Limited Distribution Drugs for the Pharmacy & Payor Benefits is vital for health systems to remain responsive and viable in a high-stakes, competitive environment. Most people we speak with say they are “killing it” in specialty pharmacy. But when asked, they don’t have access to most limited distribution drugs and they only have relationships with one or two payors in their state. To start or improve in both measures, hospitals must have someone on their side who can decipher the details and complexities of specialty pharmacy and drive results for the health system – which is ultimately improved patient outcomes – allowing them the ability to thrive in a world of changing payor reimbursements.
- CARE: Clinical Pharmacy Liaisons are essential to providing the highest quality patient care. The Liaison works to establish an initial relationship with a patient and assess their needs and concerns throughout their care journey before, during and after a clinic visit. Liaisons are the face of the hospital post discharge and help patients, providers, and pharmacists through every step of the care process. They are the linchpin in the integrated care formula that links patients, families, providers and pharmacists.
- TECHNOLOGY: A Purpose-Built Specialty Pharmacy Data Analytics Platform is another essential for success. How can every hospital be “doing specialty pharmacy” well but almost all are serving less than 10 percent of their patient population through the pharmacy? A purpose-built system is a Specialty Pharmacy infrastructure designed to maximize the benefits for both the hospital and the patient through patient support centers, purpose-built AI patient identification, 340B validation, accreditation teams, and billing and collection is a must.
Awareness of the impact of these three levers on patient care is crucial to the success of hospital-owned specialty pharmacies, and to attaining outstanding patient outcomes. But as many hospital leaders will tell you, it’s not as easy as it looks.
So, what exactly are the payoffs? Introducing, or growing a specialty pharmacy in your own hospital, is a multifaceted process that can have a tremendous payoff for the hospital. A path to reaching your hospital’s mission of care, a partnership with shared risk, and most importantly a model that improves patient care goes a long way to demonstrate the success of our Purpose-Built Specialty Pharmacy Model. The question is, how do you think this model would work best for you compared to what you are doing now with a contract specialty pharmacy or learning the hard way on your own?